Berger Amnon A, Liu Yao, Nguyen Jeanne, Spraggins Robert, Reed Devin S, Lee Christopher, Hasoon Jamal, Kaye Alan D
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Louisiana State University Shreveport School of Medicine, LA.
Orthop Rev (Pavia). 2021 Jun 22;13(2):25085. doi: 10.52965/001c.25085. eCollection 2021.
Fibromyalgia is a highly prevalent chronic pain syndrome that affects up to 4% of the population and causes significant morbidity and disability, with an increasing associated cost. Though many approaches for treatment have been tested, therapy regimens are still elusive, and efficacy is limited. This review summarizes the background of fibromyalgia and acupuncture and reviews the latest and seminal literature discussing the application of acupuncture in fibromyalgia.
Fibromyalgia is hard to treat, owing both to its chronicity and poorly understood pathophysiology and etiology. Current treatments target symptoms primarily, and few attempt to address the source. Efficacious treatment requires long-term treatment by a multidisciplinary team. Though several treatments exist, they still fall short with a substantial number of patients. Acupuncture, a form of integrative medicine, has been a part of traditional Chinese medication for generations. Evidence shows that it effectively treats different kinds of pain conditions, including migraines and chronic musculoskeletal pain. Recent studies showed evidence to support its use in fibromyalgia. Clinical trials studying acupuncture in fibromyalgia have shown improvement in pain, quality of sleep, and quality of life, though the quality of evidence is mainly low to medium. Several studies were not able to provide evidence to support real over sham acupuncture. Weighing the overall evidence paints a picture of mixed results between equivocal results to positive. In analyzing these results, one must also consider publication bias supporting the dissemination of positive results.
An increasing number of studies support the utilization of acupuncture for the treatment of fibromyalgia. Though no head-to-head comparison was able to show the superiority of acupuncture to other therapies, mounting evidence supports its use as part of multimodal approaches to treatment with additive efficacy to traditional therapy. Further research will likely provide data on effective regimens and combination therapies.
纤维肌痛是一种高度流行的慢性疼痛综合征，影响着多达4%的人口，导致显著的发病率和残疾率，且相关成本不断增加。尽管已经测试了许多治疗方法，但治疗方案仍然难以确定，疗效也有限。本综述总结了纤维肌痛和针灸的背景，并回顾了讨论针灸在纤维肌痛中应用的最新和重要文献。
纤维肌痛难以治疗，这既归因于其慢性病程，也归因于对其病理生理学和病因学的了解不足。目前的治疗主要针对症状，很少有人试图解决根源问题。有效的治疗需要多学科团队进行长期治疗。尽管有几种治疗方法，但仍有相当数量的患者疗效不佳。针灸作为一种综合医学形式，几代人以来一直是中医的一部分。证据表明，它能有效治疗各种疼痛病症，包括偏头痛和慢性肌肉骨骼疼痛。最近的研究显示有证据支持其在纤维肌痛中的应用。在纤维肌痛中研究针灸的临床试验表明，疼痛、睡眠质量和生活质量都有所改善，尽管证据质量主要为低到中等。几项研究未能提供证据支持真针灸优于假针灸。权衡总体证据，结果呈现出从模棱两可到积极的混合情况。在分析这些结果时，还必须考虑支持阳性结果传播的发表偏倚。
越来越多的研究支持使用针灸治疗纤维肌痛。尽管没有直接比较能够表明针灸优于其他疗法，但越来越多的证据支持将其作为多模式治疗方法的一部分使用，对传统疗法具有增效作用。进一步的研究可能会提供关于有效治疗方案和联合疗法的数据。
